Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC - Medicare in Syracuse, NY

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Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Syracuse, New York. Her current practice location is 713 Harrison St, Syracuse, New York. You can reach out to her office (for appointments etc.) via phone at (315) 464-7655.

Mrs Shannon Kathleen Kelley is licensed to practice in New York (license number 403004) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1902089238.

Contact Information

Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC
713 Harrison St,
Syracuse, NY 13210-2305
(315) 464-7655
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMrs Shannon Kathleen Kelley
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location713 Harrison St, Syracuse, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1902089238
  • Provider Enumeration Date: 12/10/2007
  • Last Update Date: 02/25/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 1850624263
  • Enrollment ID: I20210902002099

Medical Identifiers

Medical identifiers for Mrs Shannon Kathleen Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902089238NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 082228-1 (New York)Secondary
163W00000XRegistered Nurse 740606 (New York)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 403004 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shannon Kathleen Kelley allows following entities to bill medicare on her behalf.
Entity NamePsychiatry Faculty Practice, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881084820
PECOS PAC ID: 9234458530
Enrollment ID: O20150508000699

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shannon Kathleen Kelley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC
713 Harrison St,
Syracuse, NY 13210-2305

Ph: (315) 464-7655		Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC
713 Harrison St,
Syracuse, NY 13210-2305

Ph: (315) 464-7655

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.